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Diuretics: Pharmacological action and application in hypertension
High blood pressure, known medically as hypertension, is one of the most common cardiovascular disease and is regarded as a major risk factor for heart attacks, strokes and kidney disease. An important group of drugs for the treatment of hypertension are diuretics, also called water-reed or Diuretic known.
Mechanism of action
Diuretics act primarily on the influence of renal function. You can reduce the reabsorption of sodium (Na
+
) and water in the renal tubules, which leads to an increased excretion of urine. As a result, the blood is reduced in volume, which in turn lowers the blood pressure. In addition, you can relax by the reduction of sodium in the vessel wall, which causes a further blood-pressure-lowering effect.
The main classes of diuretics in hypertension
In the treatment of hypertension mainly three classes of diuretics are used:
Thiazide diuretics (e.g. hydrochlorothiazide): you look in the distal tubules and are considered to be the first choice in uncomplicated hypertension. Your blood pressure-lowering effect is well-documented and long-lasting.
Loop diuretics (e.g., furosemide): they are more effective and are used especially in patients with impaired renal function or heart failure.
Potassium-saving diuretics (e.g., spironolactone): This substance groups to prevent excessive loss of Potassium and are often prescribed in combination with other diuretics in order to electrolyte imbalances.
Clinical effectiveness and study location
Several large clinical studies, including the ALLHAT trial (Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial), have shown that thiazide diuretics reduce the cardiovascular morbidity and mortality in hypertensive patients significantly. You are therefore recommended in most international guidelines as a start to the Therapy of first choice.
Side effects and precautions
Despite the effectiveness of diuretics can cause side effects, including:
Electrolyte disturbances (particularly potassium and magnesium deficiency),
increased uric acid levels (with the risk of gout),
Blood sugar increase,
orthostatic hypotension (drop in blood pressure when standing Up).
Therefore, regular monitoring of electrolytes, renal values and blood pressure, in the therapy required.
Conclusion
Diuretics represent an effective and cost-effective Option in the long-term treatment of hypertension. Your application should be individually weighed and under regular medical Monitoring is performed. By the right choice of the class of substance and an appropriate dosage of a significant blood pressure reduction is at a low risk for side-effects reach.
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